Nasir Rajpoot, CEO and CSO of Histofy, reveals AI-powered screening and the triaging processes for large bowel endoscopic biopsies
The challenge of large bowel biopsies
Colorectal cancer is one of the most common cancers worldwide and a significant public health burden. Early detection is critical: when identified at the polyp or dysplasia stage, outcomes are dramatically improved. Yet, the routine workflow of extensive bowel biopsy screening places immense strain on pathology services.
- High volumes: Millions of biopsies are taken each year, particularly from screening programmes.
- Diagnostic complexity: Differentiating between normal mucosa, inflammatory changes, adenomas, and dysplasia requires experience and time.
- Workforce pressure: A global shortage of pathologists is intensifying, particularly in community and hospital settings.
The result is an unsustainable mismatch between rising demand and constrained resources – with downstream risks to timely diagnosis and patient care.
Introducing COBI
Histofy has developed COBI, an AI-powered algorithm designed to support histopathologists in the screening and triage of large bowel biopsies. COBI harnesses cutting-edge deep learning to analyse digital pathology slides at scale, providing rapid, reproducible, and clinically valuable insights.
Key capabilities include:
• Automated triage: Identifying biopsies that are likely normal and flagging those requiring urgent review.
• Quantitative insights: Highlighting suspicious regions, quantifying glandular architecture, and mapping atypical areas for closer inspection.
• Workflow integration: Seamless plug-in to digital pathology viewers and laboratory information systems, allowing COBI to function as a “silent partner” alongside pathologists.
Rather than replacing pathologists, COBI empowers them while ensuring that the right slides are prioritised, the right features are highlighted, and the right patients receive timely follow-up.
Clinical validation and collaboration
Histofy is advancing COBI through rigorous multi-site validation studies with leading academic centres and hospitals. Early results demonstrate:
- High sensitivity for detecting dysplasia and adenomas, ensuring critical cases are not missed.
- Efficiency gains: Pathologists report significant time savings when normal slides are reliably triaged.
- Reproducibility: Consistent performance across datasets, reducing inter-observer variability.
Our collaborative R&D and multi-centric validation study ensures that COBI is built with pathologists, for pathologists, embedding their expertise into the system design and ensuring that regulatory-grade evidence underpins adoption.
Transforming pathology workflows
The promise of COBI extends beyond efficiency. By embedding AI into routine bowel biopsy screening:
- Patients benefit from earlier, more reliable detection of precancerous changes.
- Clinicians gain confidence in decision-making, with AI-augmented evidence guiding downstream care.
- Healthcare systems realise cost savings through reduced diagnostic delays, fewer unnecessary procedures, and more targeted treatment pathways.
COBI is also designed with scalability in mind. Whether in national screening programmes, regional diagnostic hubs, or private laboratories, it can be deployed flexibly to meet local needs.
Harnessing AI: Looking ahead
COBI is part of Histofy’s broader mission: to harness AI for transforming the cellular pathology workflow across drug development, safety, and diagnostics. Extensive bowel biopsy screening is a critical entry point; however, the principles of AI-augmented triage, quantification, and decision support are applicable across species groups, organ systems, and disease contexts.
As digital pathology adoption accelerates worldwide, Histofy envisions a future where every pathology slide benefits from both expert interpretation and intelligent computational support. With COBI, that future is already within reach.
About Histofy
Histofy is a UK-based pathology AI company pioneering clinically robust, data-savvy solutions for pathology. From early cancer detection to drug development, Histofy partners with healthcare providers, pharma, and CROs to integrate AI seamlessly into diagnostic and research workflows.
This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.
